Communication systems

ABSTRACT

An integrated home health system includes a television-based patient station, a first provider station for providing telemedicine or other healthcare services to a patient located at the patient station, a second provider station for providing caregiver services to the patient, a third provider station for providing emergency response services to the patient and a system management station coupled together by a data network. In addition to various management operations performed on behalf of the integrated home health system, the system management station is further configured to provide various home health services to the patient located at the patient station, either alone, or in conjunction with one or more of the first, second and/or third provider stations.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.10/230,834 filed Aug. 29, 2002, now abandoned which relates to U.S.patent application Ser. No. 10/230,833 entitled “Method for Conducting aHome Health Session Using an Integrated Television-Based Broadband HomeHealth System,” which issued as U.S. Pat. No. 7,835,926, and U.S. patentapplication Ser. No. 10/230,521 entitled “Interface Device for anIntegrated Television-Based Broadband Home Health System,” which issuedas U.S. Pat. No. 7,185,282, each of which is hereby incorporated byreference in their entirety.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT

Not applicable.

REFERENCE TO A MICROFICHE APPENDIX

Not applicable.

FIELD OF THE INVENTION

The present disclosure relates generally to communication systems and,more particularly, to a communication system which integrates one ormore services.

BACKGROUND OF THE INVENTION

In an aspect, approximately 100 million Americans have a chroniccondition such as heart disease, cancer, AIDS or diabetes. Of these,approximately 8 million receive at least one home care visit per yearwhile approximately 3 million require 50 home care visits per year.Additionally, many people, particularly, the elderly, medically-at-riskand physically challenged, subscribe to personal emergency responseservices (“emergency response”) to ensure quick and easy access toemergency help whenever needed. Currently, the cost of home healthcareand emergency response services is about 43 billion dollars. As the babyboomer generation continues to age, the number of people in need of homehealthcare and/or emergency response services is expected to grow. Forexample, recent projections have estimated that the home healthcare andemergency response market will grow to over 64 billion dollars by 2006.

The extent to which remote healthcare delivery systems have beenimplemented varies widely depending on the particular type of remotehealthcare delivery system involved. Some remote healthcare deliverysystems, for example, remote caregiving systems, have rarely, if ever,been implemented. Other remote healthcare delivery systems, for example,telemedicine, have been widely implemented. Telemedicine is the use ofelectronic communication and information technologies to providehealthcare when distance separates the medical professional from thepatient. A related type of remote healthcare delivery system is commonlyknown as “telehealth.” Telehealth is the electronic provision of healthcare and information services for the direct benefit of individualpatients and their families. It includes both actual physician-patientinteractions via telemedicine, as well as education and informationservices designed to increase awareness of (and where applicable,compliance with) diagnoses and medical conditions, treatments, and goodhealth practices. While the two terms are often used interchangeably,the underlying concept of telemedicine has traditionally described theuse of technology to provide clinical medical services when thehealthcare provider and patient are separated by geographic distance.Telehealth, on the other hand, should be viewed as an expansion ontelemedicine. More specifically, telehealth not only includes clinicalservices but also non-clinical medical services such as education,research, and administrative functions.

It should be readily appreciated that the wellness and peace of mind ofmany individuals and their families would benefit greatly from a homehealth system that provides various ones of the emergency response, lifesafety, telemedicine, telehealth and remote caregiving services in asingle, integrated, home health system. It should be further appreciatedthat access to integrated home health systems would be enhanced if suchsystems were configured to exploit the existing cable broadbandinfrastructure. It is, therefore, the object of this invention toprovide an integrated home health system capable of achieving variousones of the aforementioned benefits.

SUMMARY OF THE INVENTION

In one embodiment, the present invention is directed to an integratedhome health system which includes a patient station, a broadband accessdevice coupled to the patient station, a data network coupled to thebroadband access device and a home health services provider stationcoupled to the data network. The home health services provider stationprovides home health services to the patient station over a broadbandconnection with the data network provided by the broadband accessdevice. In one aspect thereof, the patient station includes an interfacedevice, coupled to the broadband access device, which enables two-wayvideo and audio exchanges between the home health services providerstation and the patient station. In another, the patient station furtherincludes a television set coupled to the interface device. In thisaspect, video and audio signals received from the home health servicesprovider station are transmitted, by the interface device, to thetelevision set for broadcast thereby.

In other aspects of this embodiment of the invention, the patientstation may further include a digital imager and an audio receiverrespectively coupled to the interface device. In these aspects, theinterface device transmits video and audio signals received from thedigital imager and the audio receiver, respectively, to the home healthservices provider station. In still others, the patient station may alsoinclude a medical device coupled to the interface device. In theseaspects, the interface device transmits data signals received from themedical device to the home health services provider station.

In still other aspects of this embodiment of the invention, theintegrated home health system may further include a system managementstation, coupled to the data network, for authorizing the home healthprovider station to provide home health services to the patient stationand/or provide additional home health services to the patient stationover the broadband connection with the data network provided by thebroadband access device. In certain ones of these aspects, the interfacedevice would transmit data signals, received from the medical device, toboth the home health services provider station and the system managementstation. In further aspects thereof, the integrated home health systemmay further include an emergency response station coupled to the datanetwork and the public switched telephone network (“PSTN”) while thepatient station further includes an emergency response device coupled tothe interface device and the PSTN. In this aspect, the emergencyresponse device is configured for two-way audio exchanges with theemergency response station along a first path which passes through thePSTN and along a second path which passes through the interface device,the broadband access device and the data network. In other aspectsthereof, upon receiving, from the emergency response device, a requestfor connection to the emergency response station, the interface devicedetermines whether the requested connection should be established usingthe first path or the second path.

In another embodiment, the present invention is directed to anintegrated home health system which includes a patient station, aremotely located health care provider station and a remotely locatedcaregiver provider station coupled to one another by a data network. Inone aspect thereof, the integrated home health system further includes abroadband access device which couples the patient station to the datanetwork. In another, the patient station includes an interface device,coupled to the broadband access device, for enabling two-way video andaudio exchanges between the healthcare provider station and the patientstation during healthcare sessions and two-way video and audio exchangesbetween the caregiver provider station and the patient station duringcaregiver sessions. In still another, the patient station furtherincludes a television set coupled to the interface device. In thisaspect, the interface device transmits video and audio signals, receivedfrom the healthcare provider station during the healthcare sessions andfrom the caregiver provider station during the caregiver sessions, tothe television set for broadcast thereby.

In other aspects of this embodiment of the invention, the patientstation may further include a digital imager and an audio receiverrespectively coupled to the interface device. In these aspects, theinterface device transmits video and audio signals received from thedigital imager and the audio receiver, respectively, to the healthcareprovider station during the healthcare sessions and to the caregiverprovider station during the caregiver sessions. In still others, thepatient station may also include a medical device coupled to theinterface device. The interface device may transmit data signalsreceived from the medical device to the healthcare provider stationduring the healthcare sessions or, in certain further aspects thereof,to the caregiver provider station daring the caregiver sessions.

In still another aspect of this embodiment of the invention, theintegrated home health system may further include a system managementstation, coupled to the data network, for authorizing the healthcareprovider station to conduct the healthcare sessions with the patientstation and for authorizing the caregiver provider station to conductthe caregiver provider sessions with the patient station. In furtheraspects thereof, the interface device may also enable telehealthsessions between the system management station and the patient stationby transmitting video and audio signals, received from the systemmanagement station during the telehealth sessions, to the television setfor broadcast thereby.

In other aspects of this embodiment of the invention, the integratedhome health system may further include an emergency response stationcoupled to the data network and the PSTN while the patient stationfurther includes an emergency response device coupled to the interfacedevice and the PSTN. In these aspects, the emergency response device isconfigured for two-way audio exchanges with the emergency responsestation along a first path which passes through the PSTN and along asecond path which passes through the interface device, the broadbandaccess device and the data network. In other aspects thereof, uponreceiving, from the emergency response device, a request for connectionto the emergency response station, the interface device determineswhether the requested connection should be established using the firstpath or the second path.

DESCRIPTION OF DRAWINGS

FIG. 1 is a block diagram of an integrated television-based broadbandhome health system constructed in accordance with the teachings of thepresent invention;

FIG. 2 is a block diagram of a patient station of the integratedtelevision-based broadband home health system of FIG. 1;

FIG. 3 is a block diagram of an integrated home healthcare interfacedevice of the patient station of FIG. 2;

FIG. 4 is a functional block diagram of the integrated home healthcareinterface device of FIG. 3;

FIG. 5 is a block diagram of a system management station of theintegrated television-based broadband home health system of FIG. 1;

FIG. 6 is a flowchart of a method for installing the patient station ofFIG. 2 into the integrated television-based broadband home health systemof FIG. 1;

FIG. 7 is a flowchart of a method of patient interaction with theintegrated television-based broadband home health system of FIG. 1 via atelevision set;

FIG. 8a is a flowchart of a method of responding to a personal emergencyusing the integrated television-based broadband home health system ofFIG. 1;

FIG. 8b is a flowchart of a method of conducting a remote session suchas a telemedicine, telehealth or remote caregiving session using theintegrated television-based broadband home health system of FIG. 1; and

FIG. 9 is a flowchart of a method of issuing reminders to patients usingthe integrated television-based broadband home health system of FIG. 1.

DETAILED DESCRIPTION OF THE INVENTION

Referring now to FIG. 1, an integrated television-based broadband homehealth system 10 constructed in accordance with the teachings of thepresent invention will now be described in greater detail. As may now beseen, the integrated television-based broadband home health system 10includes a patient station 12, a first, or healthcare, provider station14, a second, or caregiver, provider station 16, a third, or emergencyresponse, provider station 18 and a system management station 20 coupledtogether by a data network 22, for example, the Internet or aninteractive television network. As will be more fully described below,each of the first, second and third provider stations 14, 16 and 18 areconfigured to provide various home health services to a patient locatedat the patient station 12. As will also be more fully described below,in addition to management operations performed on behalf of theintegrated television-based broadband home health system 10, the systemmanagement station 20 is also configured to provide various home healthservices to a patient located at the patient station 12, either alone,or in conjunction with one or more of the first, second and/or thirdprovider stations 14, 16 and 18.

As disclosed herein, the patient station 12 is remotely located relativeto each one of the first provider station 14, the second providerstation 16, the third provider station 18 and the system managementstation 20. Similarly, the first provider station 14, the secondprovider station 16, the third provider station 18 and the systemmanagement station 20 are remotely located relative to one another. Ofcourse, it is fully contemplated that, if desired, the integratedtelevision-based broadband home health system 10 may instead beconfigured such that various ones of the discrete home health servicesprovided by the first provider station 14, the second provider station16, the third provider station 18 and the system management station 20,respectively, may instead be provided by a common provider station. Itis further contemplated that the integrated television-based broadbandhome health system 10 may instead be configured to include additionalprovider and/or system management stations. It is contemplated that suchadditional provider and/or system management stations may be used toprovide additional home health services to a patient located at thepatient station 12 and/or management services to the integratedtelevision-based broadband home health system 10. It is furthercontemplated that such additional provider and/or system managementstations may be used to provide backup home health services to a patientlocated at the patient station 12 and/or management services for theintegrated television-based broadband home health system 10 in the eventof the failure of one or more of the first provider station 14, thesecond provider station 16, the third provider station 18 and the systemmanagement station 20. In any event, it should be clearly understoodthat the disclosed configuration of the integrated television-basedbroadband home health system 10 is purely exemplary and that numerousvariations of the disclosed configuration are possible while remainingwithin the scope of the present invention.

The first provider station 14 is a healthcare provider station wherehealthcare professionals are available to provide home healthcareservices to patients remotely located at patient stations such as thepatient station 12. Typically, the healthcare provider station 14 wouldbe located at either a physician's office or a healthcare agency orother type of organization responsible for providing home healthservices to patients at remotely located patient stations. Of course,any number of other locations would be equally suitable for use as thehealthcare provider station. The healthcare provider station 14 may becomprised of a computer system, for example, a personal computer (or“PC”), having a plurality of peripheral devices coupled thereto.Software residing on the PC should include an Internet browser, forexample, Microsoft Explorer, video conferencing software, for example,Microsoft NetMeeting, and any software applications needed for analyzingand/or displaying raw medical data received from either the patientstation 12 or the system management station 20. The peripheral devicescoupled to the PC should include a monitor suitable for viewing anyvideo images originating at the patient station 12 or the systemmanagement station 20, an audio transmitter system, for example, aspeaker system, suitable for reproducing any audio transmissionsoriginating at the patient station 12 or the system management station20, a digital imager, for example, a webcam, suitable for generatingvideo images to be transmitted to the patient station 12, an audioreceiver, for example, a microphone suitable for detecting audiblesounds to be transmitted to the patient station 12 and a printer forproducing hard copies of desired portions of any medical data displayedon the monitor. It should be clearly understood, however, that theforegoing list of components of and/or peripheral devices coupled to thePC is not intended to be comprehensive and that numerous componentsthereof and/or peripheral devices coupled thereto have been omitted forease of description.

As disclosed herein, the home healthcare services which may be providedto a patient located at the patient station 12 from a physician or otherhealthcare professional located at the healthcare provider station 14include two-way audio/video consultations, wound care and otherdiagnostics which typically use digital images, and monitoring of vitalsigns or other indicators of the health of the patient in both real-timeand store-and-forward modes. It is fully contemplated, however, thatother home health care services not specifically recited herein may alsobe provided to the patient located at the patient station 12 from thephysician or other healthcare professional located at the healthcareprovider station 14. Furthermore, it should be clearly understood that,as will be more fully described below, a typical healthcare session isnot necessarily limited to one or more exchanges between the physicianor other healthcare professional at the healthcare provider station 14and the patient located at the patient station 12. Rather, it iscontemplated that a healthcare session may also include one or moreexchanges between the physician or other healthcare professional locatedat the healthcare provider station 14 and the system management station20 and/or one or more exchanges between the patient located at thepatient station 12 and the system management station 20. Finally, otherstations (not shown), which may provide additional healthcare servicesto the patient located at the patient station 12, for example, labsystems, insurance systems, pharmacies and the like, may also be linkedto the system management station 20.

The second provider station 16 is a caregiver provider station where afamily member, close friend or other interested person may periodicallycheck on the health and well-being of a patient located at the patientstation 12. While, in the description that follows, the patient locatedat the patient station 12 has a single caregiver and that the caregiverlocated at the caregiver station 16 serves in that function for a singlepatient, it is fully contemplated that a patient may have any number ofcaregivers and that a caregiver may serve in that function for anynumber of patients. Typically, the caregiver provider station 16 wouldbe located at the home or office of the family member, close friend orother interested person acting as the caregiver for the patient locatedat the patient station 12. If desired, however, the caregiver providerstation 16 may be suitably located so as to be accessible for use byplural caregivers, each acting as a caregiver for one or more patientslocated at respective patient stations.

Like the healthcare provider station 14, the caregiver provider station16 may be comprised of a computer system, for example, a PC, having aplurality of peripheral devices coupled thereto. Software residing onthe PC should include an Internet browser, for example, MicrosoftExplorer and videoconferencing software, for example, MicrosoftNetMeeting. The peripheral devices coupled to the PC should include amonitor suitable for viewing any video images originating at the patientstation 12, an audio transmitter system, for example, a speaker system,suitable for reproducing any audio transmissions originating at thepatient station 12, a digital imager, for example, a webcam, suitablefor generating video images to be transmitted to the patient station 12and an audio receiver, for example, a microphone, suitable for detectingaudible sounds to be transmitted to the patient station 12. It should beclearly understood, however, that the foregoing list of components ofand/or peripheral devices coupled to the PC is not intended to becomprehensive and that numerous components thereof and/or peripheraldevices coupled thereto have been omitted for ease of description.Furthermore, it is fully contemplated, however, that the caregiverprovider station 16 may suitably function without the webcam and/or themicrophone. In such configurations, however, the quality of the remotecaregiving session would be reduced considerably since, while thecaregiver would still be able to monitor the patient and access patientdata, for example, vital signs or other health indices of the patient,the patient would no longer be able to look at or hear the caregiver.

The third provider station 18 is an emergency response provider station18 configured to receive emergency calls originating at the patientstation 12. The emergency response provider station 18 is staffed on a24/7 basis by one or more monitoring personnel trained to handleemergency calls originating at the patient station 12, typically, byconducting a dialogue with the patient located at the patient station 12and determining, based upon the dialogue with the patient, whether anemergency condition actually exists and, if so, the nature of theemergency. After evaluating an emergency call originating at the patientstation 12 in the aforedescribed manner, the monitoring personnel at theemergency response provider station 18 would then dispatch appropriateemergency response personnel to the patient station 12 if necessary.

The emergency response provider station 18 is further configured toreceive: (1) non-emergency videoconference calls originating at thepatient station 12 and (2) notifications, from the system managementstation 20, of potential emergency conditions at the patient station 12.If a non-emergency videoconference call is received from the patientstation 12, a monitoring personnel at the emergency response providerstation 18 would handle the videoconference call and, in the processthereof, determine whether the videoconference call was prompted by anemergency condition at the patient station 12 and whether emergencyresponse personnel should be dispatched to the patient station 12. If apotential emergency notification is received from the system managementstation 20, the monitoring personnel at the emergency response providerstation 18 would determine whether an emergency condition exists at thepatient station 12, for example, by conducting a two-way audio exchangewith the patient located at the patient station 12 and viewing a digitalimage, if appropriate. The monitoring personnel at the emergencyresponse provider station 18 would then dispatch appropriate emergencyresponse personnel to the patient station 12 if necessary. It should benoted, however, that a two-way audio exchange is but one way by whichmonitoring personnel at the emergency response provider station 18 mayevaluate conditions at the patient station 12. Under certain conditions,the monitoring personnel will be able to conduct a two-way video/audioexchange with the patient located at the patient station 12. Under otherconditions, specifically, when the patient does not respond to anaudible inquiry by the monitoring personnel, the monitoring personnelmay be able to evaluate conditions at the patient station 12 using atwo-way video/audio link, for example, by surveying the patient station12 to see if the patient has lost consciousness.

While the healthcare and caregiver provider stations 14 and 16 have asingle link—the data network 22—to the patient station 12, the emergencyresponse provider station 20 has two possible links to the patientstation 12—the first via the data network 22 and the second via publicswitched telephone network (“PSTN”) 24. As will be more fully describedbelow, the patient located at the patient station 12 may request that aconnection be established with the emergency response provider station18 using a variety of techniques, including normal videoconferencedialing, actuation of a wired emergency notification device, forexample, a panic button, or actuation of a wireless emergencynotification device, for example, a neck pendant or wrist-watch styledevice. Additionally any number of life safety sensors located at thepatient station 12 will automatically initiate a request for connectionwith the emergency response provider station 18 upon detection of analert condition, for example, when a measured physical parameter exceedsa predetermined threshold value. Life safety sensors which may belocated at the patient station 12 or, if appropriate, worn by thepatient located at the patient station 12, include smoke detectors, firedetectors, carbon monoxide detectors, wearable physiological sensors,and fall-detection sensors. Upon receipt, from the patient or a lifesafety sensor, of a request for connection with the emergency responseprovider station 18, the patient station 12 will first determine whethera link to the emergency response provider station 18 is available viathe data network 22. If a data network link is available, the patientstation 12 will then proceed to establish a link with the emergencyresponse station 18 over the data network 22. If a data network link isnot available, however, the patient station 12 will instead proceed toestablish a link with the emergency response provider station 18 overthe PSTN 24. As will also be more fully described below, the patientstation 12 may select between establishing a connection using the datanetwork or PSTN links based upon any number of criteria. For example, apower failure at the patient station 12 will cause the patient station12 to establish the link with the emergency response provider station 18via the PSTN 24.

The system management station 20 provides directory, gatekeeper, andaccess functionality and performs a wide variety of services for theintegrated television-based broadband home health system 10, the patientstation 12, the healthcare provider station 14, the caregiver providerstation 16 and/or the emergency response provider station 18. As will bemore fully described below, these services include, among others, datastorage, database management and security services for the integratedtelevision-based broadband home health system 10; life safety,telehealth provider and reminder services for the patient station 12;and potential emergency condition notification services for theemergency response provider station 18. To provide these and otherservices, the system management station 20 includes a web server (notshown in FIG. 1), one or more application servers (also not shown inFIG. 1) and a database array 26 comprised of one or more databases (alsonot shown in FIG. 1).

As will be more fully described below, the directory functionality ofthe system management station 20 involves the maintenance of a widevariety of types of information maintained in the database array 26. Thegatekeeper functionality of the system management station 20 involvesadmission control, bandwidth management, address resolution anddirectory services, user authentication and authorization, callaccounting and call routing functions for H.323 connections. Combinedwith a proxy service, a gatekeeper provides quality of service (“QoS”)capabilities to ensure high-quality H.323 videoconferencing calls overlocal area network (“LAN”) and wide area network (“WAN”)infrastructures. The proxy also enhances security by working withfirewalls to perform H.323 endpoint address translation. Accessfunctionality which, like directory functionality, is more fullydescribed below, involves the control of access to the resources of thesystem management station 20, for example, by the healthcare providerstation 14 during a home health session.

Briefly, the data storage services provided by the system managementstation 20 includes storing health-related data collected from orotherwise provided by the patient located at the patient station 12. Forexample, the health-related data may include data acquired by one ormore electronic devices used to measure the vital signs or other healthindices of the patient, answers to the questions contained in one ormore questionnaires, electronically filled out by the patient, andresponses to system and medication reminders for compliance monitoring.The database management services provided by the system managementstation 20 includes the scheduling of healthcare, caregiver and/oreducational sessions for a patient located at the patient station 12 andthe scheduling of data collection times at which the vital signs and/orother health indices of a patient located at the patient station 12 areto be measured. The database management services provided by the systemmanagement station 20 further includes the scheduling of an appropriatetype and number of reminders to be issued in connection with eachscheduled session and/or data collection time. The security servicesprovided by the system management station 20 include controlling accessto electronic patient records and other confidential informationmaintained in the one or more databases forming the database array 26,controlling the establishment of connections between a physician orother healthcare professional requesting initiation of a telemedicine ortelehealth session between the healthcare provider station 14 and thepatient station 12 and controlling the establishment of connectionsbetween a family member or other person requesting initiation of acaregiver session between the caregiver provider station 16 and thepatient station 12.

The telehealth services which may be provided to a patient located atthe patient station 12 by the system management station 20 includevarious types of education services. For example, the system managementstation 20 may stream instructional videos, over the data network 22, tothe patient station 12, either upon receipt of a request by the patientlocated at the patient station 12 or by the physician or otherhealthcare professional located at the healthcare provider station 14.Variously, the educational videos may be streamed on demand or at apre-arranged time scheduled in advance. It is further contemplated thatthe educational services provided by the system management station 20may include interactive educational services, again either upon receiptof a request by the patient located at the patient station 12 or thephysician or other healthcare professional located at the healthcareprovider station 14, which periodically requires input from the patient,for example, in the form of answers to questions asked by theeducational video.

Using the reminder services provided by the system management station20, the patient located at the patient station 12 may be issuedmedication reminders intended to remind the patient to take prescriptionor non-prescription medications or system reminders intended to remindthe patient: (1) to measure their vital signs or other indices of theirhealth using various monitoring devices forming part of the patientstation 12; (2) of an upcoming telemedicine or telehealth session with aphysician or other health care professional located at the healthcareprovider station 12; (3) of an upcoming remote caregiving session with afamily member or other caregiver located at the caregiver providerstation 16; or (4) of an upcoming telehealth session being broadcast bythe system management station 20. As will be more fully described below,both medication and system reminders issued by the reminder service ofthe system management station 20 may be comprised of video messages,audio messages, images, text messages or a combination thereof.

The reminders issued by the reminder service of the system managementstation 20 may either be of a first type which requires a response oracknowledgement or of a second type which does not require a response oracknowledgement. Of course, if an immediate response to the first typeof reminder is not convenient, the patient can temporarily reset thereminder for reissuance after a pre-determined of time. If the patientlocated at the patient station 12 fails to reset, respond or otherwiseacknowledge a reminder requiring a response or acknowledgement, thesystem management station 20 may notify the emergency response providerstation 18 of a potential emergency condition. Conversely, reminderswhich do not require a response from the patient located at the patientstation 12 are typically configured to be broadcast, at the patientstation 12, for a pre-determined period of time. At the conclusion ofthe broadcast, the reminder is typically repeated, either immediately orafter a pre-determined time period. The reminder is typically repeatedfor a pre-determined number of times and then ends.

In conjunction with the reminder service, the system management station20 maintains compliance records which may be periodically retrieved, forexample, by a physician or other healthcare professional located at thehealthcare station 14, to determine how well the patient is complyingwith the various reminders issued by the reminder service of the systemmanagement station 20. Typically, the compliance records will maintain alist of the date, time and type of all reminders issued by the systemmanagement station 20. The compliance records will also maintain thepatient's responses and/or failures to respond to those reminders.

As may be further seen in FIG. 1, the patient station 12 is coupled tothe data network 22 by a broadband access device 28. The broadbandaccess device 28 may be a cable modem, a digital subscriber line (“DSL”)modem, fixed and/or wireless connections, a satellite data modem, oranother broadband data access device. As will be more fully describedbelow, the patient station 12 exchanges Internet protocol (“IP”) datapackets with the data network 22 via the broadband access device 28.

Referring next to FIG. 2, the patient station 12 will now be describedin greater detail. As may now be seen, a central component of thepatient station 12 is an integrated home health system interface device36 which, as will be more fully described below, enables the delivery ofvarious home health services such as telemedicine, telehealth,caregiver, emergency response and life safety services to a patientlocated at the patient station 12. While the internal configuration ofthe integrated home health system interface device 36 will be describedin greater detail with respect to FIGS. 3-4, below, the interconnectionof the integrated home health system interface device 36 with thebroadband access device 28 of the integrated television-based broadbandhome health system 10 as well as with various other components of thepatient station 12 shall first be described.

As may be seen in FIG. 2, the integrated home health system interfacedevice 36 has a first input line coupled to a television signal source34, an input/output (“I/O”) line coupled to the broadband access device28 and an output line coupled to a TV set 38. The television signalsource 34 is an RF modulated composite signal typically provided, asillustrated in FIG. 1, by an antenna, a cable television (“CATV”) settop box, or a satellite television service. The television signal source34 processes the data signals received at the various TV broadcastfrequencies into a format suitable for display by TV 38. However, afterappropriate processing by the television signal source 34, rather thantransmitting the processed signals directly to the TV 38 as is common inthe art, the television signal source 34 instead transmits the processeddata signals to the integrated home health system interface device 36.

As will be more fully described below, absent contravention resultingfrom the receipt of certain signals from the broadband access device 28or other devices forming part of the patient station 12, the integratedhome health system interface device 36 will pass the TV broadcastsignals received from the television signal source 34 to the TV 38.Contravention, i.e., a temporary interruption of the TV broadcastsignals received from the television signal source 34, will occur undera variety of conditions. For example, the initiation of a telemedicinesession with a patient located at the patient station 12 by a physicianor other health care professional located at the healthcare providerstation 14, the initiation of a caregiver session by a family member orother interested person located at the caregiver provider station 16 orthe initiation of a telehealth session by the system management station20 will cause the integrated home health system interface device 36 totemporarily interrupt the passing of TV broadcast signals received onthe first input line from the television signal source 34 to the TV 38in favor of video and audio signals received on the I/O line from thebroadband access device 28 as part of the telemedicine, caregiver ortelehealth session initiated at the healthcare provider station 14,caregiver provider station 16 or system management station 20,respectively. Variously, the video signals displayed on the TV 38 aspart of a telemedicine, caregiver, telehealth or other home healthsession may produce an image that fills the entire screen, a portion ofthe screen or, if desired, merely overlays the TV broadcast signalreceived from the television signal source. The integrated home healthsystem interface device 36 will similarly interrupt the passing of TVbroadcast signals received on the first input line from the televisionsignal source 34 to the TV 38 in favor of messages received on the I/Oline from the broadband access device 28 as part of the reminderservices provided by the system management station 20. Finally, the homehealth system interface device 36 will interrupt the passing of TVbroadcast signals to the TV 38 whenever the patient located at thepatient station 12 initiates a home health session using patientinterface device 52, for example, a hand-held infra-red (“IR”) remote.

In addition to the foregoing devices, a number of other devices are alsocoupled to the integrated home health system interface device 36. Theyinclude a telephone handset 30, a digital imager 40, for example, acamera, an audio receiver 42, an audio transmitter 44, a first medicaldevice 46, a second medical device 48, a third medical device 50 and anemergency response device 54. The digital imager 40, which, for example,may be positioned on a top side surface of the housing of the integratedhome health system interface device 36, is coupled to an input line ofthe integrated home health system interface device and used to capturevideo images of the patient located at the patient station 12 forviewing at the healthcare provider station 14 during telemedicine,telehealth or other healthcare sessions, for viewing at the caregiverprovider station 16 during caregiver sessions or for viewing at theemergency response provider station 18, in order to evaluate whether anemergency condition exists at the patient station 12, during anemergency response session initiated in response to either anotification of a possible emergency by the system management station20, request for establishment of a videoconferencing connection by thepatient located at the patient station 12, initiation of an emergencycall by the patient located at the patient station 12 or initiation of alife safety session by a life safety device located at the patientstation 12.

The audio receiver 42, for example, a microphone, is coupled to an inputline of the integrated home health system interface device 36 and usedfor detecting audible sounds uttered by the patient located at thepatient station 12, typically, as part of one of the aforementionedtelemedicine, telehealth, other healthcare, remote caregiving, emergencyresponse or life safety sessions. Conversely, the audio transmitter 44is coupled to an output line of the integrated home health systeminterface device and used to generate audible sounds for detection bythe patient station 12. Typically, audible sounds generated by the audiotransmitter 44 are the same as those generated by the TV 38. However, inthe event that the TV 38 has been turned off by the patient located atthe patient station 12, the audio transmitter 44 will generate audiblemessages, for example, reminder messages, for the patient located at thepatient station 12. If desired, the TV 38 and the audio transmitter 44may be configured to operate only in the alternative. In such aconfiguration, the audio transmitter 44 will operate whenever the TV 38is turned off but will not generate audible messages when the TV 38 isturned on. If desired, the audio receiver 42 and the audio transmitter44 may either be discrete devices as illustrated in FIG. 2 or, in thealternative, may be configured as a single device such as aspeakerphone. Finally, the telephone handset 30 is used to enhance theprivacy of the healthcare, caregiver and other home health sessionsconducted at the patient station 12. As previously set forth, in atypical home health session, the TV 38 generates both the video and theaudio at the patient station 12. However, should the patient not wish tohave their conversation with a home health provider overheard, thepatient may activate the telephone handset 30. By doing so, the audiosignal generated by the integrated home health system interface devicewould be rerouted from the TV 38 to the telephone handset 30. As aresult, the audio portion of the home health session would no longer beaudible, except by the person wearing the telephone handset 30. Thetelephone handset 30 would also be useful whenever the patient locatedat the patient station initiated a videoconference, for example, withmonitoring personnel at the emergency response provider station 18.Variously, the telephone handset 30 may be configured as a wired device,as illustrated in FIG. 2 or a wireless device (not shown).

Each one of the first, second and third medical devices 46, 48 and 50are coupled to input lines of the integrated home health systeminterface device 36 and are used to acquire medical data, typically,measurements of vital signs and/or other indices of the health of thepatient located at the patient station 12. As disclosed herein, each oneof the first, second and third medical devices are universal serial bus(“USB”) devices coupled to USB ports (not shown) forming part of theintegrated home health system interface device 36. Depending on thenumber of USB ports provided on the integrated home health systeminterface device 36 and the number of medical devices to be coupled tothe integrated home health system interface device 36, the medicaldevices may either be coupled directly to a USB port in a manner similarto the illustrated coupling between the integrated home health systeminterface device 36 and the first medical device 46 or may be chained toanother USB medical device coupled to the USB port in a manner similarto the illustrated coupling between the third medical device 50 and thesecond medical device 48.

It should be clearly understood the configuration of the patient station12 illustrated in FIG. 2 in which three medical devices are coupled tothe integrated home health system interface device 36 is purelyexemplary and that any number of medical devices may be coupled to theintegrated home health system interface device 36. Generally, eightmedical devices, all of which are commercially available, will coverover 90% of the medical data acquisition needs for the variousconfigurations of the patient station 12 of the integratedtelevision-based broadband home health system 10. These eight devicesinclude a blood pressure device for measuring the blood pressure of thepatient located at the patient station 12, a weight scale for measuringthe weight of the patient located at the patient station 12, a bloodglucose monitor for measuring the blood glucose level of the patientlocated at the patient station 12, a spirometer for measuring thebreathing capacity of the lungs of the patient located at the patientstation 12, an electrocardiograph for generating an electrocardiogram(“EKG”) showing the variations in electric force which trigger thecontractions of the heart of the patient located at the patient station12, a pulse oximeter for measuring the oxygen level in the blood of thepatient located at the patient station 12, a digital camera, preferably,one having resolution of at least one megapixel, for performing remotewound care or other diagnostics requiring high resolution digitalimagery and an electronic stethoscope for collecting heart, lung andbowel sounds. Accordingly, it is contemplated that the patient station12 may be configured to acquire the desired medical data using anycombination of these eight or other suitable medical devices.

As further illustrated in FIG. 2, the emergency response device 54 is adiscrete device coupled to the integrated home health system interfacedevice 36 and to the PSTN 24. In an alternate configuration of theinvention, however, the emergency response device 54 may instead formpart of the integrated home health system interface device 36.Regardless, however, an emergency call to the emergency responseprovider station 18 may be actuated using either a wired emergencynotification device 57, for example, a panic button, or a wirelessemergency notification device 56, for example, a neck pendant. It iscontemplated that the wired emergency notification device 57 may beconsiderably simpler in configuration than the wireless emergencynotification device. In response to actuation of either the wired orwireless emergency notification device 57 or 56, a two-way audioconnection is established between the patient station 12 and theemergency response provider station 18. As the wired emergencynotification device 57 is physically linked to the emergency responsedevice 54 which, in turn, is physically linked to the integrated homehealth system interface device 36, it can be safely presumed that thepatient actuating the wired emergency notification device is inrelatively close proximity to the audio receiver 42 and the audiotransmitter 44. Accordingly, the audio receiver 42 and the audiotransmitter 44 may be used when establishing the two-way audioconnection between the patient station 12 and the emergency responseprovider station 18. Use of the wireless emergency notification device56 is contemplated when the patient is no longer in proximity to theemergency response device 54. As a result, the wireless emergencynotification device 57 should be equipped with an audio receiver/audiotransmitter system, suitable for conducting a two-way audio dialoguetherewith.

In one embodiment, one or more life safety devices 32 are also linked tothe emergency response device 54. Generally, most life safety devicesare configured to automatically detect the presence of a specific typeof emergency situation, monitored for such detections on a 24/7 basisand cannot be disarmed readily. For example, fire detectors, smokedetectors, flood detectors, carbon monoxide detectors, wearablephysiological sensors and fall-detection sensors may all be deemed to bevarious types of life safety devices suitable for use as the life safetydevice 33. Upon detection of an emergency condition, the life safetydevice 32 transmits a signal to the emergency response device 54 whichis handled, by the emergency response device 54, in a manner similar tothat used when either the wireless emergency notification device 56 orthe wired emergency notification device 57 is actuated. Accordingly, inresponse to receipt of a signal from the life safety device 32, theemergency response device 54 initiates an emergency call to theemergency response provider station 18. If desired, the emergencyresponse device 54 may also notify the emergency response providerstation 18 that the call is being established in response to a detectionof the emergency condition by the life safety device 32. By doing so,the monitoring personnel located at the emergency response providerstation 18 would be better equipped to evaluate the situation at thepatient station 12.

It is contemplated that data to be delivered to the healthcare providerstation 14, caregiver provider station 16, emergency response providerstation 18 and system management station 20 over the data network 22 mayoriginate at a variety of the devices forming part of the patient carestation 12. These devices may include, for example, the digital imager40, the audio receiver 42, the first medical device 46, the secondmedical device 48, the third medical device 50, the patient interfacedevice 52, and/or the emergency response device 54. Data received by theintegrated home health system interface device 36 from any one or moreof the aforementioned devices is passed to the cable modem or otherbroadband access device 28. In turn, the broadband access device 28places the data on the data network 22 for delivery to the desireddestination.

Referring next to FIG. 3, the integrated home health system interfacedevice 36 will now be described in greater detail. It should be clearlyunderstood that, as illustrated in FIG. 3, the integrated home healthsystem interface device 36 has been greatly simplified for ease ofdescription and that numerous conventional components thereof, forexample, the power distribution system, have been omitted from thedrawings. As may now be seen, the integrated home health systeminterface device 36 includes a first processor board 58, a secondprocessor board 60 and a radio frequency (“RF”) modulator 62. As will bemore fully described below, the first processor board 58, which, forexample, may be a low cost, general purpose computing motherboard, iscoupled to the cable modem 32 for handling upstream and downstreamexchanges of IP data packets with various ones of the healthcareprovider station 14, the caregiver provider station 16, the emergencyresponse provider station 18 and the system management station 20. Themotherboard 58 is further coupled to the emergency response device 54for determining, on behalf of the emergency response device 54, the pathto be used when issuing an emergency call to the emergency responseprovider station 18 in response to the detection, by the emergencyresponse device 54, of the actuation of either the wireless emergencynotification device 56 or the wired emergency notification device 57.Under certain other conditions, the motherboard 58 will detect theoccurrence of a potential emergency condition and notify the emergencyresponse provider station 18 of the same. Finally, the motherboard 58 isalso coupled to the first, second and third medical devices 46, 48 and50 to enable the upload of medical data therefrom.

The second processor board 60, which, for example, may be a video board,is coupled to the motherboard 58 and the RF modulator 42. Of course,while illustrated as a single board, the video board 60 is, in fact,plural board level components which collectively perform the variousfunctionalities disclosed herein. More specifically, the video board 60receives digital video output signals from the motherboard 58 fortransmission to the RF modulator 62. The video board 60 also receivesdigital audio output signals, again from the motherboard 58, fortransmission to the TV 38 and/or the audio transmitter 44. As previouslyset forth, if the patient located at the patient station 12 activatesthe telephone handset 30, the digital audio signals which would havebeen transmitted by the video board 60 to the RF modulator 62 areinstead transmitted, by the video board, to the telephone handset 30.The video board 60 also receives audio signals, from the emergencyresponse device 54 for transmission to the audio transmitter 44. Thevideo board 60 further receives video and audio input signals from thedigital imager 40 and the audio receiver 42, respectively, forprocessing and forwarding to the motherboard 58. Under certainconditions, however, the audio signals originating at the audio receiver42 and received by the video board 60 will instead be destined for theemergency response device 54. Finally, the video board 60 receives dataand/or commands from the patient located at the patient station 12 viathe patient interface device 52. As will be more fully described below,using the patient interface device 52, the patient may perform a varietyof tasks. For example, the patient may review their schedule ofappointments and/or reminders, acknowledge the receipt of a reminder,initiate a videoconference with the emergency response provider station18 or initiate a telehealth session with the system management station20.

The RF modulator 62 has two input lines, a first coupled to thetelevision signal source 34 and a second coupled to the video board 60.Each one of the television signal source 34 and the video board 60functions as a source of video and/or audio signals to the RF modulator62. The signals received from the television signal source 34 are in aformat suitable for display by the TV 38. However, the signals receivedfrom the video board 60 are not. In the absence of video and/or audiosignals from the video board 60, the RF modulator 62 designates thetelevision signal source 34 as the signal source for the TV 38.Accordingly, the RF modulator 62 will pass the signals received from thetelevision signal source 34 to the TV 38. Upon detection of video and/oraudio signals from the video board 60, the RF modulator 62 willdesignate the video board 60 as the signal source for the TV 38. The RFmodulator will then convert the video and/or audio signals received fromthe video board 60 into a format suitable for display by the TV 38 andthen pass the converted signals to the TV 38 for display.

Of course, it should be clearly understood that the particularconfiguration of the integrated home health system interface device 36disclosed herein is purely exemplary and that numerous modifications maybe made thereto while remaining within the scope of the invention. Forexample, the integrated home health system interface device 36 isdisclosed herein as having first and second processor boards 58 and 60.If desired, however, the second processor board 60 may be eliminated byoff-loading the functionality residing thereon onto the first processorboard 58. Conversely, additional processor boards may be used byoffloading selected functionality currently disclosed as residing oneither the motherboard 58 or the video board 60 onto a third processorboard, for example, a daughter board coupled to either the motherboard58 or the video board 60. Of course, the interconnections between thevarious processor boards of the integrated home health system interfacedevice 36 and the interconnections between the integrated home healthsystem interface device 36 and other devices forming part of the patientstation 12 may vary depending on the particular functionality offloadedfrom one processor board to another.

It should be further understood that, rather than the discrete devicesillustrated in FIG. 2, certain devices which, together with theintegrated home health system interface device 36, form the patientstation 12, may, if desired, be incorporated into the integrated homehealth system interface device 36. For example, in one alternateconfiguration thereof, the cable modem or other broadband access device28 is incorporated into the integrated home health system interfacedevice 36. In another, the television signal source 34 is incorporatedinto the integrated home health system interface device 36. Of course,in still another, both the cable modem or other broadband access device28 and the television signal source 34 are incorporated into theintegrated home health system interface device 36. Such a configurationwould have considerable appeal to consumers attracted to thoseconfigurations of the invention which require only a single “box”between the cable outlet or other source of the RF modulated compositeTV signal and the TV 38. Finally, in still yet another configuration,the integrated home health system interface device 36 may be configuredsuch that the emergency response device 54 is a component thereof. Insuch a configuration, the integrated home health system device 36 wouldinclude a third processor board, coupled to both the motherboard 58 andthe video board 60, on which the functionality of the emergency responsedevice 54 resides.

Referring next to FIG. 4, the functionality residing within theintegrated home health system interface device 36 will now be describedin greater detail. As may now be seen, residing on each of themotherboard 58 and the video board 60 are plural managers, each of whichprovides a discrete functionality to respective ones of the motherboard58 and the video board 60. Each manager residing on either themotherboard 38 or the video board 60 may be embodied in hardware,software or a combination thereof. The plural managers residing on themotherboard 58 include a first, or home health system, manager 64, asecond, or medical device, manager 66, a third, or reminder, manager 68and a fourth, or emergency response device, manager 70. The pluralmanagers residing on the video board 60, on the other hand, include afirst, or audio/video, manager 72 and a second, or remote, manager 74.

Turning first to the plural managers residing on the motherboard 58, thehome health system manager 64 handles downstream and/or upstreamexchanges between the cable modem 32 and the various managers residingon either the motherboard 58 or the video board 60, more specifically,the medical device manager 66, the reminder manager 68, the emergencyresponse device manager 70, the audio/video manager 72 and the remotemanager 74. The medical device manager 66 handles the issuance ofcommands to and the acquisition of data from the first, second and thirdmedical devices 46, 48 and 50. More specifically, each of the first,second and third medical devices 46, 48 and 50 may forward acquiredmedical data to the medical device manager 66 in either“store-and-forward” or “real-time” modes. In the store-and-forward mode,the patient periodically collects medical data, typically, either ontheir own volition or in response to the issuance of a reminder by thereminder service of the system management station 20.

During the collection of medical data, the first, second and thirdmedical devices 46, 48 and 50 may or may not be coupled to theintegrated home health system interface device 36. If coupled to theintegrated home health system interface device 36, the medical devicemanager 66 will have instructed the first, second and third medicaldevices 46, 48 and 50, respectively, to forward all medical data to themedical device manager 66 upon the acquisition thereof. Accordingly,upon the acquisition of medical data by one or more of the first, secondand third medical devices 46, 48 and 50, the acquired data is promptlyforwarded by the medical device to the medical device manager 66. Themedical device manager 66 passes the acquired data to the home healthsystem manager 64 which, in turn, forwards the acquired data to thecable modem 32 for upstream transfer, via the data network 22 to thesystem management station 20 for storage thereat in a selected databaseforming part of the database array 26. Conversely, if the first, secondand third medical devices 46, 48 and 50 are not coupled to theintegrated home health system interface device 36, data acquired by thefirst, second and third medical devices will be held in a local memorythereof until they are subsequently coupled to the integrated homehealth system interface device 36. Upon coupling thereto, the medicaldevice manager 66 will issue a command to the first, second and thirdmedical devices which causes them to initiate a dump of the medical dataacquired thereby to the medical device manager 66. Subsequent handlingof the medical data received by the medical device manager 66 will thenproceed in the manner hereinabove described.

Acquisition of medical data in real-time mode is typically performed inconjunction with a telemedicine session initiated by a physician orother healthcare professional located at the healthcare provider station14. As part of the part of the telemedicine session, and in conjunctionwith oral instructions transmitted to the patient located at the patientstation over the two-way video/audio link, the physician or otherhealthcare professional will issue an instruction to the systemmanagement station 20 to initiate a real-time collection of specifiedtypes of medical data. In turn, the system management station 20 willissue an instruction to the medical device manager 66, again, via thehome health system manager 64, to begin real-time data collection forthe specified types of medical data. The medical device manager 66selects appropriate ones of the first, second and third medical devices46, 48 and 50 which are configured to collect the specified types ofmedical data and issues instructions to the selected ones of the first,second and third medical devices 46, 48 and 50 to begin collection ofthe medical data. As the selected ones of the first, second and thirdmedical devices 46, 48 and 50 begin to acquire medical data from thepatient located at the patient station 12, the acquired medical data istransported to the home health system manager 64 in the mannerpreviously described and, from the home health system manager 64, istransferred upstream, via the cable modem 32 and the data network 22, toboth the healthcare provider station 14 for inclusion in a real-timedisplay and to the system management station 20 for storage in thedatabase 26. The real time data acquired using the selected ones of thefirst, second and third medical devices 46, 48 and 50 may be of either asingle reading of the acquired type of medical data or a continuousreading of the acquired type of medical data. Of the various devicespreviously identified as typical medical devices suitable for use as anyone of the first, second and third medical devices 40, 48 and 50, theblood pressure monitor, the blood glucose monitor and the spirometer areamong those medical devices used to acquire a single reading for a typeof medical data while the electrocardiograph and the pulse oximeter areamong those medical devices used to acquire a continuous reading whichextends over a period of time for a type of medical data.

When the system management station 20 determines that a reminder shouldbe issued at the patient station 14, a request for generation of areminder message is issued by the system management station 20. Therequest is transported to the home health system manager 64 via the datanetwork 22 and the cable modem 32 and, in turn, is passed to thereminder manager 68. Upon receipt of the request, the reminder manager68 issues a command to the audio/video manager 72 to begin generation ofa reminder message. The audio/video manager 72 generates a remindermessage comprised of video and/or audio signals and transports thegenerated video and/or audio signals to the TV 38 and/or the audiotransmitter 44 so that the reminder message may be viewed and/or heardby the patient located at the patient station. Further details of thedisclosed method for generating reminder messages is set forth ingreater detail with respect to FIG. 9, below.

As previously set forth, reminder messages generated by the audio/videomanager 72 may require that the patient located at the patient station12 reply to or otherwise acknowledge viewing and/or bearing the remindermessage. If so, the patient located at the patient station 12 replies toor otherwise acknowledges the remainder message using the patientinterface device 52, for example, by actuating a “reminder received”button on the patient interface device 52. Signals issued by the patientinterface device 52 are analyzed by the remote manager 74. If the remotemanager 74 determines that the signal issued by the patient interfacedevice 52 indicates that the patient viewed and/or heard the remindermessage, the remote manager 74 forwards a “reminder received” message tothe reminder manager 68. If the reminder manager 68 receives thereminder message within a pre-selected period of time after issuance ofa reminder, the reminder manager 68 concludes that the reminder wasreceived by the patient located at the patient station 12. Conversely,if the reminder manager 68 fails to receive the reminder message withinthe pre-selected time period, the reminder manager 68 concludes that thereminder was not received by the patient located at the patient station12. As before, further details as to how the disclosed method forgenerating reminders proceeds upon determining that a reminder messagewas either received or not received by the patient located at thepatient station 12 is set forth in greater detail with respect to FIG.9, below.

The emergency response device manager 70 receives emergency callsoriginating at the emergency response device 54 and, as is more fullydescribed below with respect to FIG. 8a , determines the type ofconnection to be established between the emergency response device 54and the emergency response provider station 18. If the emergencyresponse device manager 70 determines that a data network connection isto be established, the emergency response device manager 70 initiatesestablishment of the connection by issuing a request for connection tothe home health system manager 64. Conversely, if the emergency responsedevice manager 70 determines that a PSTN connection is to beestablished, the emergency response device manager 70 returns a messageto the emergency response device 54 instructing the emergency responsedevice 54 to initiate a request for connection to the emergency responseprovider station 18 over the PSTN 24.

Turning next to the plural managers residing on the video board 60, theaudio/video manager 72 handles video signals to be used in generatingimages for display on the TV 38 and/or audio signals to be used inreproducing audible sounds using either the TV 38 and/or the audiotransmitter 44. It is contemplated that the aforementioned video and/oraudio signals may originate from a variety of sources. For example,during a telemedicine, telehealth or other healthcare session initiatedby a physician or other healthcare professional located at thehealthcare provider station 14, video images and audible soundsrespectively detected by a webcam and microphone at the healthcareprovider station 14 are converted into video and audio signals,respectively, and transported via the Internet 22 and the cable modem 32to the home health system manager 64. In turn, the home health systemmanager 64 transfers the video and audio signals to the audio/videomanager 72 where a series of video images and/or audible sounds aregenerated from the received video and/or audio signals, respectively.Similarly, video images and audible sounds respectively detected by awebcam and microphone at the caregiver provider station 16 are convertedinto video and/or audio signals in the same manner and transported tothe audio/video manager 72, again for generation of a series of videoimages and audible sounds therefrom. Streaming video, originating at thesystem management station 20, for example, in response to initiation ofa telehealth session by a physician or other healthcare professional atthe healthcare provider station 14, is similarly transported to theaudio/video manager 72 for generation of a series of video images andaudible sounds therefrom.

As previously set forth, the reminder manager 68 attends to the transferof reminder messages, some of which require a response oracknowledgement of receipt thereof, to the audio/video manager 72 forthe generation of video and/or audio reminder messages therefrom. Asfurther previously set forth, various control signals may be generatedby the patient located at the patient station 12 using the patientinterface device 52. A first control signal which may be generated bythe patient interface device 52 indicates that the reminder message wasreceived. Accordingly, in response to receipt of the first controlsignal, the remote manager 74 issues a return message, to the remindermanager 68, advising the reminder manager 68 that the reminder messagewas received. Based upon whether a reminder message requires a responseor acknowledgement thereof and whether a return message was receivedfrom the remote manager 74, the reminder manager 68 will determinewhether to issue a notification, to the emergency response providerstation 18, of a potential emergency condition at the patient station12. If the reminder manager 68 determines to issue such a notification,the notification is passed to the home health system manager 64 forupstream transmission over the cable modem 32 and the Internet 22.Finally, and as will be more fully described below with respect to FIG.7, below, if the signal generated by the patient interface device 52 andreceived by the remote manager 74 is a second control signal, the remotemanager 74 will issue an instruction to the audio/video manager 72 todisplay selected ones of a plurality of screenings illustrating thevarious controls which may be actuated by the patient located at thepatient station 12 using the patient interface device 52.

It should be readily appreciated by one skilled in the art that variousones of the functionalities herein identified as residing within theplural managers residing on a first one of the pair of processor boards58 and 60 may, if desired, reside on the other one of the pair ofprocessor boards 58 and 60. It should be further appreciated that all ofthe functionalities identified as residing within the plural managersresiding on one or the other of the pair of processor boards 58 and 60may instead reside on a single, unified, processor board whichincorporates all of the functionality herein described as residingwithin the integrated home health system interface device 36. Finally,it should be appreciated that plural ones of the disclosed managers may,if desired, be combined into a single, common, manager whichincorporates the functionality of the plural ones of the disclosedmanagers combined into the single, common, manager.

Referring next to FIG. 5, the system management station 20 will now bedescribed in greater detail. Again, it should be clearly understoodthat, as illustrated in FIG. 5, the system management station 20 hasbeen greatly simplified and that various components of the systemmanagement station 20 not deemed necessary for an understanding of thepresent invention have been omitted from the drawing for ease ofdescription. As may now be seen, the system management station 20includes plural servers, specifically, web server 76, telehealthservices provider application server 78, event scheduling applicationserver 80, video conferencing application server 82, electronic patientrecord (“EPR”) management application server 84, medical deviceapplication server 96 and database array management server 96 and pluraldatabases, specifically, questionnaire database 86, telehealth mediacontent database 88 event schedule database 90, video conferencingauthorization database 92 and electronic patient records database 94,which collectively comprises the database array 26. As disclosed herein,a discrete application resides on each of the application servers 78,80, 82 and 84. It is fully contemplated, however, that, in oneembodiment of the invention, plural ones of these applications mayreside on a common server. As further disclosed herein, a separatecategory of data is stored on each of the databases 86, 88, 90, 92 and94. It is further contemplated, however, that in one embodiment of theinvention, plural, ones of these types of data may be stored in a commondatabase.

The web server 76 maintains content which may be viewed by usersaccessing the web server 76 via the Internet. Using a web browserresiding on the computer system respectively located thereat, the webserver 76 may be accessed via the data network 22 from the healthcareprovider station 14, the caregiver provider station 16 or the emergencyresponse provider station 18 of the integrated television-basedbroadband home health system 10. The web server 76 may also be accessedfrom the patient station 12 using the home health system manager 64. Thetelehealth services provider application server 78, the event schedulingapplication server 80, the video conferencing application server 82, theEPR management application server 84 and the medical device applicationserver 96 all function in support of the web server 76. Accordingly, ifthe user accessing the content maintained by the web server 76 executesa selected one of the application servers 78, 80, 82, 84 and 86, the webserver 76 would transport the user's commands to the selected one of theapplication servers 78, 80, 82, 84 and 86 for execution.

Various ones of the commands transported to the application servers 78,80, 82, 84 and 86 may involve a read or write operation to a selectedone of the databases 86, 88, 90, 92 and 94. For such commands, theselected one of the application servers 78, 80, 82, 84 and 86 wouldaccess the selected one of the databases 86, 88, 90, 92 and 94 andexecute the operation. Others of the commands transported to theapplication servers 78, 80, 90, 92 and 94 may involve initiating anaction at the patient station 12. For such commands, the selected one ofthe application servers 78, 80, 82, 84 and 86 would generate a commandmessage initiating the action at the patient station 12 and transfer thegenerated command message to the home health system manager 64 via theweb server 70, the data network 22 and the cable modem 32. Still othersof the commands may involve both an access to one of the selecteddatabases 86, 88, 90, 92 and 94 and, using the information obtained fromthe accessed database, initiating an action at the patient station 12.After executing the command, the selected one of the application servers78, 80, 82, 84 and 86 would return the results to the web server 76 forviewing by the user. Of course, the content which allows a user toexecute commands using one or more of the application servers 78, 80,82, 84 and 86 is restricted content. Accordingly, prior to allowing auser access to the restricted content, the web server 76 would firstredirect the user to an access server (not shown) for execution of anauthentication and/or authorization session and, only uponauthentication and/or authorization thereof, would the web server 76allow the user access to the restricted content which allows the user toexecute commands using a selected one of the application servers 78, 80,82, 84 and 86.

The telehealth services provider application 78 provides varioustelehealth services to a patient located at the patient station 12. Onesuch telehealth service provided by the telehealth services provider 78is educational services. More specifically, various educational programsare stored in the telehealth media content database 88. If the patientwishes to view one of these programs, the patient would access thetelehealth services provider application server 78 through the webserver 76, view a list of available programs stored in the telehealthmedia content database 88 and select a program to be transmitted to thepatient station 12. The telehealth services provider application 78would then retrieve the selected program from a location within thetelehealth media content database 88 and stream the selected program tothe patient station 12. Of course, it is contemplated that thetelehealth media content database 88 may also maintain interactiveprograms which periodically require user feedback and which vary thecontent subsequently transmitted to the user based upon that feedback.In addition to transmitting a selected educational program in responseto a request by the patient located at the patient station, educationalprograms may also be scheduled in advance, for example, by a physicianor other healthcare professional located at the healthcare providerstation 14 or a caregiver located at the caregiver provider station 16.If scheduled in advance, the event scheduling application server 80would issue a message to the telehealth services provider applicationserver 78 at the time when the program is to be transmitted. The messagetransmitted to the telehealth services provider 78 would identify theprogram to be transmitted and specify the destination for thetransmission. The telehealth services provider application server 78would then attend to retrieval of the identified program from thetelehealth media content database 88 and the subsequent transmission ofthe identified program to the specified destination.

Another telehealth service provided by the telehealth services provider78 is collection of information, typically medical in nature, frompatients. More specifically, various medical questionnaires are storedin the questionnaire database 86 and may be retrieved therefrom by thetelehealth services provider application server 78 for viewing by apatient located at the patient station 12. For example, a physician orother healthcare provider at the healthcare provider station 14 may,during a healthcare session with a patient located at the patientstation 12, request that the patient answer a questionnaire. Thephysician or other healthcare professional may then access, through theweb server 76, the telehealth services provider application server 78,obtain a list of questionnaires stored in the questionnaire database 86and select a questionnaire to be transmitted to the patient station 12.The telehealth services provider application server 78 would thenretrieve the selected questionnaire program from a location within thequestionnaire database 86, and transmit the selected questionnaire tothe patient station 12. Responses returned from the patient station 12would be forwarded by the web server 76 to the EPR managementapplication server 84 for entry at a specified location in theelectronic patient records database 94.

The event scheduling application server 80 may be used to schedulevarious types of events, for example, telemedicine, telehealth, orcaregiver sessions for the patient located at the patient station 12.Another type of event which may be scheduled using the event schedulingapplication server 80 are reminders of any of the aforementioned typesof events. A user, for example, a physician or other healthcareprofessional located at the healthcare provider station 14, schedulingan event would access the event scheduling application server 80 throughthe web server 76. The user would then generate an entry for storage inthe event schedule database 90. Typically, such an entry would includethe type of event, the time at which the event is to occur, and thelocation of the event. Preferably, the entries maintained in the eventschedule database 90 would be sortable by both the time at which theevent shall occur and the patient for which the event has beenscheduled. By doing so, a subsequent user accessing the event schedulingapplication server 80, for example, a caregiver located at the caregiverprovider station 16 may review the schedule of events for the patientand may avoid scheduling a prospective remote caregiving session at atime which conflicts with a previously scheduled healthcare session.

Additionally, the event scheduling application server 80 periodicallychecks the contents of the event schedule database 90 for entries which,based upon the time at which they are scheduled to occur, need to beexecuted. If the event scheduling application server 80 locates an entryrelated to an event which is scheduled to occur within a pre-selectedperiod of time, the event scheduling application server 80 retrieves theentry from the event schedule database 90 for execution. Of course, theprocess used to execute the entry will vary depending on the particulartype of entry that was retrieved. For example, if the entry was areminder, the event scheduling application server 80 would generate areminder message for transmission to the patient station 12. If,however, the entry indicated that a telehealth session had beenscheduled, the event scheduling application server 80 would notify thetelehealth services provider application server 78 of the particularvideo or questionnaire to be transmitted to the patient station 12 orother type of educational session to be initiated. The telehealthservices provider application server 78 would then retrieve theappropriate video, questionnaire or other appropriate content fromeither the questionnaire database 86 or the telehealth media contentdatabase 88 and attend to the transmission of the retrieved content tothe patient station 12 in the manner previously described.

The video conference application server 82 serves to authenticate and/orauthorize users who desire to initiate a two-way video/audio conferencewith the patient located at the patient station 12. For example, if acaregiver located at the caregiver provider station 14 wishes toinitiate a remote caregiving session, the caregiver would first accessthe video conference application server 82 through the web sever 76. Thecaregiver would then provide identifying information, for example, auser name and/or password to the video conference application server 82.In turn, the video conference application server 82 would compare theprovided identifying information to a list of authorized personsmaintained in the video conference authorization database 92. Typically,the video conference authorization database 92 would include a series ofentries, each identifying a user who is authorized to conduct ahealthcare or remote caregiving session and the pattern with whom theuser is authorized to conduct such a session. Preferably, each entrywould also identify the level of access to the patient station 12granted to that user. For example, the various users requesting sessionsmay variously be granted two-way audio transmission rights, two-wayvideo transmission rights, medical device data acquisition rights or thecombination of all three. The video conferencing application server 82may also place a time limit on the rights granted. For example, while itis expected that a physician or other health care professional would nothave any time limits placed on the rights granted thereto, it may bedesirable to limit the duration of access rights granted to caregivers,thereby limiting the duration of remote caregiving sessions. Afterdetermining the rights to be granted and/or time limit placed thereon,the videoconference application server would, subject to the determinedlimitations, establish the requested session.

The EPR management application server 84 serves to manage electronicpatient records maintained in the electronic patient records database96. For example, a physician or other healthcare professional located atthe healthcare provider station 14 may access the EPR managementapplication server 84 through the web server 76, view a list of patientrecords maintained in the electronic patient record database 94 andselect a patient record for review. Once retrieved, the physician orother healthcare professional may also add additional information to theelectronic patient record. For example, a physician or other healthcareprofessional 14 who retrieved the electronic patient record for apatient in connection with a telemedicine or other healthcare sessionmay wish to add a diagnosis, course of treatment, protocols, response toprotocols and other notes to the electronic patient record either duringor at the conclusion of the telemedicine or other healthcare session.Typically, the electronic patient records database is comprised of aseries of entries, each corresponding to a patient being served by theintegrated television-based broadband home health system 10. Included ineach entry would be identifying information for a patient, the locationof the patient station for that patient, a list of sessions conducted orother contacts with the patient and a record of all events.

The medical device application serves 96 controls the writing ofacquired medical data from the patient station 12. As previously setforth, whenever medical data for a patient is acquired from the first,second and third medical devices 46, 48 and 50 located at the patientstation 12, all such medical data is transferred, via the web server 76to the medical device application server 96. The medical deviceapplication server 96 decrypts the received medical data, parses thedecrypted medical data and then writes the parsed medical data for to anentry maintained in the electronic patient records database 94 for thatpatient. The medical device application server 96 then transmits anacknowledgement to the home health system manager 64 which, in turn,instructs the medical device manager 66 to issue an instruction to themedical device from which the medical data now stored in the electronicpatient record database 94 originated to clear its local memory.

Various administrative functions for the system management station maybe performed by a system administrator using the database arraymanagement server 98, typically, using a local interface device 99 suchas computer system having a monitor, keyboard and mouse. For example,whenever a new patient is added, the system administrator may create aninitial patient record, typically, containing only identifyinginformation for the patient and the location of the patient station 12for the patient, in the electronic patient records database. Similarly,other tasks commonly performed by the system administrator would includemodifying the list of persons authorized to conduct healthcare orcaregiver sessions maintained in the video conferencing authorizationdatabase 92, adding or editing programs maintained in the telehealthmedia content database 88 and adding or editing questionnairesmaintained in the questionnaire database 86.

Referring next to FIG. 6, a method of provisioning an existingtelevision-based integrated broadband home health system, for example,the television-based integrated broadband home health system 10, for anew patient station, for example, a patient station similarly configuredto the patient station 12, will now be described in greater detail. Themethod commences at step 100 and, at step 102, the integratedtelevision-based broadband home health system is provisioned for the newpatient station. To do so, the electronic patient records database 94must be modified to add an additional patient record for the describingthe patient located at the new patient station to the series ofelectronic patient records maintained in the electronic patient recordsdatabase 94. For example, the database array management server 96 maycreated an additional electronic patient record within the availablespace of the electronic patient records database 94. While, aspreviously set forth, a wide variety of information is maintained in theelectronic patient record for a patient, upon initial provisioning ofthe new patient station, the electronic patient record to be added tothe electronic patient records database 94 may initially be limited tobasic patient identification information. Typically, the initialprovisioning of the new patient station will also include creating anauthorization record in the video conferencing database 92 whichidentifies each healthcare provider station 14 authorized to conducttelemedicine, telehealth or other healthcare sessions with the newlyadded patient station using two-way video/audio conferencing over thedata network 22. The authorization record would further identify eachcaregiver provider station 16 authorized to conduct remote caregivingsessions with the newly added patient station, again using two-wayvideo/audio conferencing over the data network 22. If desired, ratherthan merely identifying the authorized healthcare and caregiver providerstations 14 and 16, the authorization record may further identify theperson or persons who may initiation such sessions at the healthcare andcaregiving stations 14 and 16, respectively.

Upon provisioning the integrated television-based broadband home healthsystem 10 at step 102, the method proceeds to step 104 for provisioningof the newly added patient station. Unlike the data provisioning at step102, step 104 involves the provisioning of the physical equipment toform part of the newly added patient station. Typically, the physicalprovisioning of the newly added patient station would involve the CATVservice provider to install a cable modem and set top box at thelocation of the newly added patient station. The CATV service providerwould then install a television-based integrated broadband home healthsystem interface device between the set top box and the TV. Finally themedical and other peripheral devices forming part of the newly addedpatient station would be plugged into the television-based integratedbroadband home health system interface device.

Upon completing the physical provisioning of the newly added patientstation, the method proceeds to step 106 where the newly added patientstation is initialized. Once powered up, the television-based integratedbroadband home health system interface device will receive an IP addressand then attempt to contact the system management station 20 to performthe initialization process. Continuing on to step 108, if an IP addressis not received and/or communication with the system management station20 fails, it is determined that initialization of the newly addedpatient station has failed and the method proceeds to step 110 where anderror message is generated, by the television-based integrated broadbandhome health system interface device, for display on the TV. The methodthen ends at step 118.

Returning to step 108, if communication with the system managementstation 20 is established, it is determined that initialization of thenewly added patient station has been successful and the method proceedsto step 112 where the web server 76 issues an instruction to the EPRmanagement application server 84 to access the electronic patientrecords database 94 to display the electronic patient record entered atstep 102 for the newly added patient station. The web server 76 displaysthe electronic patient record for the newly added patient station,typically, as a series of screens of data and asks that the patientlocated at the newly added patient station to confirm the accuracy ofthe electronic patient record. By confirming the accuracy of theelectronic patient record, the electronic patient record is deemed tohave been validated.

The method then proceeds to step 114 where the configuration of thenewly added patient station 12 is verified. To do so, thetelevision-based integrated broadband home health system interfacedevice will identify each peripheral plugged into its USB ports andconfirm various ones of its settings, for example, the date and the timeof day. The identity of the peripherals plugged into thetelevision-based integrated broadband home health system interfacedevice is transferred to the web server 76 which, in turn instructs theEPR management application server 84 to update the electronic patientrecord for the newly added patient station to include the identity ofeach peripheral device coupled to the newly added patient station. Bydoing so, the configuration of the newly added patient station isverified and the method proceeds to step 116 where the telehealthservices provider application server 78 retrieves an introductory videofrom the telehealth media content database 88 and streams the retrievedvideo over the data network 22 where it is displayed on the TV of thenewly added patient station. It is contemplated that the introductoryvideo will provide guidance on the basic operation of the patientstation 12, instruct the patient how to use the various medical devicescoupled to the television-based integrated broadband home health systeminterface device 36 and teach the patient how to use the patientinterface device 52 to control various operations of the patient station12. Having completed the provisioning of an existing television-basedintegrated broadband home health system to include a newly added patientstation, the method ends at step 118.

Referring next to FIG. 7, a method by which a patient interacts with theintegrated television-based broadband home health system of FIG. 1 via atelevision set will now be described in greater detail. The methodcommences at step 120 and, at step 122, the patient initiates TVviewing. As previously set forth, TV viewing may be periodicallyinterrupted for previously scheduled events maintained in the eventschedule database 90 for the system management station 20. Morespecifically, the event scheduling application server 80 monitorsscheduled events for each patient station 12 forming part of theintegrated television-based broadband home health system 10. Upondetection of a scheduled event record maintained in the event scheduledatabase 90 which has a time/date field matching the time/date of thesystem clock for the event scheduling application server 80, the eventscheduling application server 80 retrieves the scheduled event recordfor execution. Upon retrieval of the scheduled event record from theevent schedule database 90, the event scheduling application server 80constructs a command message for transport to the patient station 12over the data network 22.

Continuing on to step 124, if a command message originating at the eventscheduling application server 80 is received by the home health systeminterface device 36, the home health system interface device 36 shallinterrupt TV viewing by the patient. Accordingly, the method thenproceeds to step 126 for determination of the type of interruption to beexecuted. More specifically, the command message is received by the homehealth system manager 64 which, in turn, passes the command message tothe reminder manager 68. At step 126, the reminder manager 68 examinesthe command message to determine if TV viewing is to be interrupted toremind the patient of an upcoming event that was previously scheduled.If so, the method proceeds to step 128 where a reminder is issued to thepatient by executing steps 216 through 238 of FIG. 9, below. The methodthen proceeds to step 140 where, upon conclusion of the reminder, TVviewing is resumed.

Returning to step 126, if, however, it is determined that examination ofthe command message does not indicate that TV viewing is to beinterrupted to remind the patient of an upcoming event that waspreviously scheduled, the method instead proceeds to step 130 where thereminder manager 68 determines, based upon the prior examination of thecommand message, if the command message indicates that TV viewing is tobe interrupted to conduct a remote caregiving session. If so, the methodproceeds to step 132 where a remote caregiving session is conducted byexecuting steps 188 through 208 of FIG. 8b . The method then proceeds tostep 140 where, upon conclusion of the remote caregiving session, TVviewing is resumed.

Returning to step 130, if however, it is determined that examination ofthe command message does not indicate that TV viewing is to beinterrupted to conduct a remote caregiving session, the method insteadproceeds to step 134 where the reminder manager 68 determines, basedupon the prior examination of the command message, if the commandmessage indicates that TV viewing is to be interrupted to conduct atelemedicine or other home healthcare session. If so, the methodproceeds to step 136 where a telemedicine or other home healthcaresession is conducted by executing steps 188 through 208 of FIG. 8b . Themethod then proceeds to step 140 where, upon conclusion of thetelemedicine or other home healthcare session, TV viewing is resumed.

Returning to step 134, if, however, it is determined that examination ofthe command message does not indicate that TV viewing is to beinterrupted to conduct a telemedicine or other home healthcare session,the method instead proceeds to step 138 where, having eliminated allother possible scheduled events for which TV viewing may be interrupted,a telehealth or other educational session is conducted by executingsteps 188 through 208 of FIG. 8b . The method then proceeds to step 140wherein, upon conclusion of the telehealth or other education session,TV viewing is resumed.

Proceeding on to step 142, the patient continues TV viewing and, at step144, the patient may decide to select a home health system menu whichmay be viewed on the TV 38. To do so, the patient generates an IRcontrol signal to the integrated health system interface device 36 bydepressing or otherwise actuating a home health system display button onthe patient interface device 52. The IR control signal generated therebyis received by the remote manager 34 which determines, based upon theparticular IR control signal received thereby, the appropriate action oractions to take in response thereto. More specifically, in response toreceipt of a home health system display command, the remote manager 74instructs the audio/video manager 72 to interrupt TV viewing in favor ofa screening listing one or more operations which the patient mayinitiate using the patient interface device 52 and, if desired,instructions on how to initiate each of the listed operations.

Proceeding on to step 146, by either depressing or otherwise actuating a“call” button on the patient interface device 32 or by navigating, onthe screening to the videoconference selection and then depressing orotherwise actuating an “enter” button on the patient interface device52, the patient will initiate establishment of a videoconference withmonitoring personnel at the emergency response provider station 18. Morespecifically, by depressing the call button on the patient interfacedevice 52, an IR control signal is generated, again, for receipt by theremote manager 74. Here, however, in response to receipt of a callsignal, the remote manager 74 issues a request for videoconferenceconnection to the home health system manager 64. In turn, the homehealth system manager 64 establishes a two-way video/audio connectionwith the emergency response provider station 18 over the data network22. Upon establishment of the two-way video/audio connection, thepatient will be able to see and hear monitoring personnel at theemergency response provider station 18 on the TV 38 while the monitoringpersonnel at the emergency response provider station 18 can see and hearthe patient from the video and audio signals respectively generated bythe digital imager 40 and the audio receiver 42. Once the two-wayvideo/audio connection is established, the method proceeds to step 148where a video conference between the patient and the monitoringpersonnel at the emergency response provider station 18 is conducted byexecuting steps 168 et seq. of FIG. 8a . The method then returns to step144 where the patient may select other options form the home healthcaremenu.

Returning now to step 144, either depressing or otherwise actuating a“educational video” button on the patient interface device 52 or bynavigating, on the screening to the educational video selection and thendepressing or otherwise actuating an “enter” button on the patientinterface device 52, an IR control signal is generated for receipt bythe remote manager 74. The method will then proceed to step 150 where,in response to receipt of the educational video signal, the remotemanager 74 will issue an instruction to the audio/video manager 72 toreplace the screening currently displayed on the TV 38 with a nextscreening which lists the various education videos which may be viewedon the TV 38. The patient would then navigate to a desired educationalvideo and again depress or otherwise actuate the enter button on thepatient interface device 52. By doing so, the method proceeds to step152 for viewing of the selected educational video, again, by executingsteps 188-208 of FIG. 8b . After completing viewing the selected videoat step 152 or, if the patient declined to select a video at step 150,the method returns to step 144 where the patient may continue to selectoptions from the home healthcare menu or may release the menu, therebyproceeding to step 154 where TV viewing is resumed. From step 154, themethod will either return to step 124 if the patient continues to viewTV or, if the patient has finished viewing TV, the method ends at step156.

Referring next to FIG. 8a , a method of responding to a personalemergency using the integrated television-based broadband home healthsystem 10 will now be described in greater detail. The method commencesat step 158 and, at 160, the emergency response device 54 detects theissuance of an emergency call by the patient located at the patientstation 12. Variously, the emergency call may be issued by depressing awired emergency notification device 57, for example, a panic button, orby depressing a wireless emergency notification device 56, for example,a pendant. By issuing an emergency call, a personal emergencynotification process is initiated by the emergency response device 54issuing a personal emergency notification message to the emergencyresponse device manager 70. The method then proceeds to step 162 wherethe emergency response device manager 70 determines if the integratedhome health system interface device 36 is powered up. If it isdetermined at step 162 that a power failure has occurred at theintegrated home health system interface device 36, the method proceedsto step 174 where the emergency response device manager 70 instructs theemergency response device 54 to establish a two-way audio connectionwith the emergency response provider station 18 via the PSTN 24. Themethod would then proceed to step 176 where a dialogue is conductedbetween the patient located at the patient station 12 and monitoringpersonnel located at the emergency response provider station 18. Basedupon that dialogue, the monitoring personnel located at the emergencyresponse provider station 18 determines whether an emergency situationexists at the patient station 12 and, if so, will dispatch appropriateemergency personnel to address the emergency situation. Having completedan evaluation of the emergency call originated at the patient station,the method ends at step 186.

Returning to step 162, if the emergency response device manager 70determines that the integrated home health system interface device 36 ispowered up, the method instead proceeds to step 164 where the emergencyresponse device manager 70 checks with the home health system manager 64to see if a data network connection with the emergency response providerstation 18 via the data network 22 is available. If the home healthsystem manager 64 advises the emergency response device manager 70 thata data network connection is not available, the method will againproceed through steps 174 and 176 for establishing a two-way audioconnection via the PSTN 24, conducting a dialogue between the patientlocated at the patient station 12 and monitoring personnel located atthe emergency response provider station 18 and evaluating the emergencycall based upon that dialogue before ending at step 186.

If, however, it is determined by the home health system manager 64 atstep 164 that a data network connection over the data network 22 isavailable, the method proceeds to step 166. At step 166, the home healthsystem manager 64 determines whether the emergency call originated atthe wired emergency notification device 57 or the wireless emergencynotification device 56. If the emergency call originated at the wiredemergency notification device 57, it may be possible for the monitoringpersonnel at the emergency response provider station 18 to view thepatient located at the patient station 12 using the digital imager 40.Accordingly, the method would proceed to step 168. If however, theemergency call originated at the wireless emergency notification device56, the monitoring personnel at the emergency response provider station18 would not be able to view the patient located at the patient station12. Accordingly, the method would instead proceed to step 178.

If, from step 166, the method proceeded to step 168, the home healthsystem manager 64 would, at step 168, check the level of QoS of the datanetwork 22 to determine if the QoS of the data network 22 is sufficientto support a two-way video/audio connection between the patient station12 and the emergency response provider station 18. If the data networkis able to support a two-way video/audio connection between the patientstation 12 and the emergency response provider station 18, the methodproceeds to step 170 where a two-way video/audio connection between thepatient station 12 and the emergency response provider station 18 isestablished. The method then proceeds to step 172 where the monitoringpersonnel located at the emergency response provider station 18 conductsa two-way video/audio dialogue with the patient located at the patientstation over the data network 22 to evaluate the emergency call. Themethod would then again end at step 186.

Returning to step 168, if, upon checking the QoS level for the datanetwork 22, the home health system manager 64 determines that the QoSlevel is insufficient to support a two-way video/audio connectionbetween the patient station 12 and the emergency response station 18over the data network 22, the method proceeds to step 182 where the homehealth system manager 64 determines if the QoS of the data network 22 issufficient to support a two-way audio connection and a one-way streamingvideo connection between the patient station 12 and the emergencyresponse provider station 18 If the data network 22 can support atwo-way audio/one-way streaming video connection between the patientstation 12 and the emergency response provider station 18, the methodproceeds to step 184 where two-way audio and upstream video connectionsare established between the patient station 12 and the emergencyresponse provider station 18. The method then continues on to step 172and proceeds in the manner previously described.

If upon checking the QoS level for the data network 22 and determining,at step 182, that the QoS level for the data network 22 is insufficientto support a two-way audio/one-way Streaming video connection betweenthe patient station 12 and the emergency response station 18 over thedata network 22 or upon determining, at step 166, that the emergencycall was received from the wireless notification device 56, the methodproceeds to step 178 where the health system manager 64 determines ifthe QoS of the data network 22 is sufficient to support a two-way audioconnection between the patient station 12 and the emergency responseprovider station 18 If the data network 22 can support a two-way audioconnection between the patient station 12 and the emergency responseprovider station 18, the method proceeds to step 180 where a two-wayaudio connection over the data network 22 is established between thepatient station 12 and the emergency response provider station 18. Themethod then continues on to step 172 and proceeds in the mannerpreviously described.

If, however, the health system manager 64 determines, at step 178, thatthe QoS of the data network 22 is insufficient to support a two-wayaudio connection between the patient station 12 and the emergencystation 18, the method returns to step 174 for establishment of atwo-way audio connection, over the PSTN 24, between the patient station12 and the emergency response station 18. The method would then proceedin the manner previously described.

Referring next to FIG. 8b , a method of conducting a remote session, forexample, a telemedicine, telehealth or remote caregiving session withthe patient located at the patient station 12, using the integratedtelevision-based broadband home health system 10 will now be describedin greater detail. The method starts at step 188 and, at step 190, arequesting station, for example, the healthcare provider station 14 orthe caregiver provider station 16 accesses, via the data network 22 andthe web server 76, the event scheduling application server 80 toinitiate scheduling of a remote session with the patient station 12.While it is contemplated that a remote session is typically scheduled inadvance, it is contemplated that a remote session may be scheduledcontemporaneously. The requesting station provides the event schedulingapplication server 80 with information regarding the proposed remotesession and, if there are no previously scheduled remote sessions thatwould conflict with the proposed remote session, the event schedulingapplication server 80 would schedule the remote session. It is furthercontemplated that, to avoid the requesting station repeatedly attemptingto schedule remote sessions which conflict with previously scheduledsessions, it is contemplated that, when accessing the event schedulingapplication server 80, a list of previously scheduled events, sortableby patient, date and time of session and duration of session, will beretrieved from the event schedule database 90 and made available forreview by the home health provider located at the requesting station.

To schedule a remote event, the requesting station should provide, tothe event scheduling application server 80, the type of remote sessionto be scheduled, the patient station 12 with which the remote sessionwill be conducted, the date and time at which the remote session is tobegin, the duration of the remote session, whether any reminders of theremote session should be issued to the patient station, the type ofreminders to be issued, the date and time at which the reminders are tobe issued, the message to be transmitted to the patient station 12, theduration of the reminder message, whether the message is to be reissuedand the frequency at which the reminder message is to be reissued. Usingthe information provided by the requesting station, the event schedulingapplication server 80 constructs an appropriate number of scheduledevent entries in the event schedule database 90. Typically, a firstentry is constructed for the remote session itself and an additionalentry is constructed for each remote session reminder to be issued.

After scheduling a remote session, the method proceeds to step 192. Atstep 192, the event scheduling application server 80 periodically checksthe contents of the event schedule database 90 for events requiringexecution. Thus, if a reminder (or reminders) of the session werescheduled at step 190, the event scheduling application server 80 willdetermine that the reminder (or reminders) require execution when thedate and time at which they were scheduled for execution matches thecurrent date and time for the event scheduling application server 80.The method then proceeds to step 194 for execution, for each reminderscheduled, of the reminder process set forth in FIG. 9 and described ingreater detail below. After execution of the reminder process of FIG. 9for each reminder scheduled or, if no reminders were scheduled, themethod then proceeds to step 196 for initiation of a scheduled remotesession.

Proceeding on to step 196, the requesting station initiates a scheduledsession by accessing, via the data network 22 and the web server 76, thevideo conference application server 82. Upon accessing the videoconference application server 82, the requesting station provides thevideo conference application server 82 with identifying information, forexample, a user name and password. The method then proceeds onto step198 where the video conference application server 82 checks the providedidentifying information against identifying information for a series ofauthorized stations and/or users maintained in the video conferencingauthorization database 94. If a check of the video conferencingauthorization database 92 indicates that the requesting station isauthorized to conduct a session with the patient station 12, the methodproceeds to step 200 where, in preparation for the remote session, therequesting station would access, via the data network 22 and the webserver 76, the EPR management application server 84. By accessing theEPR management application server 84, the requesting station mayretrieve, from the electronic patient records database 84, theelectronic patient record for the patient located at the patient station12.

Proceeding on to step 202, the video conference application server 82establishes a two-way video and audio connection between the requestingstation and the patient station and, at step 204, the remote session isconducted. During the remote session, the home health provider locatedat the requesting station may perform a variety of services for thepatient location at the patient station 12 including, but notnecessarily limited to, reviewing the current electronic patient recordfor the patient, conducting a dialogue with the patient, visuallyobserving the mannerisms of the patient, visually examining thepatient's body, acquiring real-time medical data for the patient andupdating the electronic patient record for the patient. The session willcontinue until terminated at step 206. It is contemplated that a varietyof techniques may be used to terminate a session. Typically, the sessionwill continue until the requesting station terminates the two-wayvideo/audio connection with the patient station 12. If the session istime limited, however, it is contemplated that, after issuance of one ormore warnings to the requesting station and/or the patient station 12,the two-way video/audio connection may be terminated by the videoconference application server 82.

Referring next to FIG. 9, a method of issuing reminders to patientslocated at patient stations, for example, the patient station 12, usingthe integrated television-based broadband home health system 10 will nowbe described in greater detail. The method starts at step 210 and, atstep 212, the event scheduling application server 80 determines that ascheduled reminder should be issued at the patient station 12. To do so,the event scheduling application server 80 periodically checks thecontents of the event schedule database 90 for events requiringexecution and, if a reminder event stored in the event schedule database90 is scheduled for execution at a date and time matching the currentdate and time for the event scheduling application server 80, the eventscheduling application server 80 determines that the scheduled reminderis to be executed.

Proceeding on to step 214, the reminder event stored in the eventschedule database 90 is retrieved and a data packet is constructed fortransmission to the patient station 12 indicated as the destination ofthe reminder message. The constructed data packet should contain datafrom which the audible and/or visible reminder message to be broadcastat the patient station 12 may be constructed, the type of remindermessage to be broadcast at the patient station 12, the duration of thereminder message, whether the reminder message is to be reissued and thefrequency at which the reminder message is to be reissued. Onceconstructed, the data packet is transmitted, over the data network 22,to the patient station 12. The home health system manager 64 passes thearriving data packet to the reminder manager 68 where the data packet ischecked for type of reminder message to be broadcast and, if thereminder message is the type of message requiring a response within afirst pre-selected period of time, the reminder manager 68 would begin acountdown of the first pre-selected time period and then pass the datafrom which the audible and/or visible reminder message to be broadcastmay be constructed to the audio/video manager 72 where the audibleand/or visible reminder message is constructed from the received data.Conversely, if the reminder message is the type of message requiring oneor more reissues thereof after a second pre-selected period of time, thereminder manager 68 would begin a countdown of the second pre-selectedperiod of time and then pass the data from which the audible and/orvisible reminder message to be broadcast may be constructed to theaudio/video manager 72 where, as before, the audible and/or visiblereminder message is constructed from the received data.

Proceeding on to step 216, the audio/video manager 72 checks to see ifthe TV 38 is turned on. If the TV 38 is on, the method proceeds to step218 where the audio/video manager 72 transmits the audible and/orvisible reminder message to the TV 38 for the visual and/or audiblebroadcast thereof. If, however, the audio/video manager 72 determinesthat the TV 38 is turned off, the method will instead proceed to step220 where the audio/video manager 72 transmits an audible portion of theaudible and/or visible reminder message to the audio transmitter 44 forthe audible broadcast thereof. From either step 218 or step 220, themethod then proceeds to step 222. If, at step 222, the reminder manager68 indicates that no reply to the reminder message is required, themethod proceeds to step 240 for determining if the reminder messagerequires reissue. If the reminder manager 68 determines that thereminder message does not have to be reissued, the method ends at step238. If, however, the reminder manager 68 determines that the remindermessage is to be reissued and that the second pre-determined period oftime has elapsed, the method returns to step 216 where the audio/videomanager 72 resets the countdown of the second pre-determined period oftime and timer and retransmits the reminder message to the audio/videomanager 72 for the rebroadcast thereof. The method then repeats untilthe reminder message no longer requires reissue. Generally, the remindermanager 68 maintains a reminder reissue count and ends retransmission ofthe reminder message when the reminder re-issue count reaches zero.

Returning now to step 222, if a reply to the reminder message isrequired, the method proceeds to step 224 for determination as towhether the reminder manager 68 has received a reply, in the form, of areply message received from the remote manager 74, to the remindermessage. If the reply has been received, the method proceeds to step 226where the reply message received by the reminder manager 68 is forwardedto the EPR management application server 84 at the system managementstation 20 where the record for the patient located at the patientstation 12 stored in the electronic patient records database 94 isupdated to include an indication of the reply to the reminder message.The method then ends at step 238.

Returning to step 222, if the reminder manager 68 has not yet received areply from the remote manager 74, the method proceeds to step 230 toawait expiration of the first pre-selected period of time. The methodcycles through step 224 and step 230 until either the reply message isreceived from the remote manager or the first pre-selected period oftime expires. If, at step 230, the first pre-selected period of timeexpires without receipt of a reply message, the method proceeds to step232 where the reminder manager 68 constructs a failure messageindicating that no reply to the reminder message was ever received. Thefailure message is transferred to the forwarded to the EPR managementapplication server 84 at the system management station 20 where, at step234, the record for the patient located at the patient station 12 storedin the electronic patient records database 94 is updated to include anindication of the failure to reply to the reminder message. The methodthen proceeds to step 236 where the reminder manager 68 constructs apotential emergency condition message indicating that a potentialemergency condition may be present at the patient station. The potentialemergency message is then forwarded to the emergency response providerstation 18 where, upon receipt of the potential emergency message, themonitoring personnel located at the emergency response station 18 willinvestigate further in the manner previously described to determine ifan emergency condition exists at the patient station 12. The method thenends at step 238.

Thus, there has been described and illustrated herein, a home healthsystem which integrates one or more of personal emergency response, lifesafety, telemedicine, telehealth, and remote caregiving services into asingle, television-based, broadband, networked, home health system.However, those skilled in the art should recognize that numerousmodifications and variations may be made in the techniques disclosedherein without departing substantially from the spirit and scope of theinvention. Accordingly, the scope of the invention should only bedefined by the claims appended hereto.

What is claimed is:
 1. A communication system comprising: a first interface configured to receive first content from a first service provider via radio frequency; a second interface configured to receive second content from a second service provider via a broadband data network; and a third interface configured to transmit the first content to a user device, to transmit the second content to the user device based upon a determination to interrupt the first content, and to transmit at least the second content to the user device independent of a request from the user device, wherein one or more of the first interface, the second interface, and the third interface, facilitates two-way communication between the user device and one or more of the first service provider and the second service provider.
 2. The communication system of claim 1, wherein the first content comprises a television signal.
 3. The communication system of claim 1, wherein the second content comprises one or more of an alert, a command message, a notification, and a reminder.
 4. The communication system of claim 1, wherein the third interface is further configured to selectively and simultaneously transmit the first content and the second content to the user device.
 5. The communication system of claim 1, wherein one or more of the first service provider and the second service provider is a home health services provider.
 6. The communication system of claim 1, wherein one or more of the first service provider and the second service provider is a television service provider.
 7. The communication system of claim 1, wherein the third interface is selectively operable to transmit one or more of video signals and audio signals to the user device.
 8. The communication system of claim 1, further comprising a system management station coupled to the broadband data network, the system management station remotely located relative to the user device, wherein the system management station is configured to authorize one or more of the first service provider and the second service provider to communicate with the user device.
 9. The communication system of claim 1, wherein the determination to interrupt the first content is based upon one or more of a predefined schedule, a type of content included in the second content, or an urgency of the second content.
 10. A communication system comprising: a first interface configured to receive first content from a first service provider via radio frequency; a second interface configured to receive second content from a second service provider via a broadband data network; and a user device in communication with the first interface and the second interface, the user device configured to receive the second content upon determining to interrupt the first content, and to receive at least the second content independent of a request from the user device, wherein one or more of the first interface and the second interface facilitates two-way communication between the user device and one or more of the first service provider and the second service provider.
 11. The communication system of claim 10, wherein the user device is further configured to render one or more of the first content and the second content.
 12. The communication system of claim 10, wherein the user device is further configured to overlay one or more of the first content and the second content.
 13. The communication system of claim 10, wherein the first content comprises a television signal.
 14. The communication system of claim 10, wherein the second content comprises one or more of an alert, a notification, and a reminder.
 15. The communication system of claim 10, wherein the user device is further configured to selectively and simultaneously render the first content and the second content.
 16. The communication system of claim 10, wherein one or more of the first service provider and the second service provider is a home health services provider.
 17. The communication system of claim 10, wherein one or more of the first service provider and the second service provider is a television service provider.
 18. The communication system of claim 10, further comprising a system management station coupled to the broadband data network, the system management station remotely located relative to the user device, wherein the system management station is configured to authorize one or more of the first service provider and the second service provider to communicate with the user device.
 19. The communication system of claim 10, wherein the determination to interrupt the first content is based upon one or more of a predefined schedule, a type of content included in the second content, or an urgency of the second content.
 20. A communication system comprising: an interface device comprising a first communication path configured to receive first content from a first service provider via radio frequency and a second communication path configured to receive second content from a second service provider via a broadband data network; and a user device in communication the interface device, wherein the interface device is further configured to transmit the first content to the user device and to transmit the second content to the user device based upon a determination to interrupt the first content independent of a request from the user device for transmission of the second content, and wherein the interface device facilitates two-way communication between the user device and one or more of the first service provider and the second service provider.
 21. The communication system of claim 20, wherein the user device is further configured to render one or more of the first content and the second content.
 22. The communication system of claim 20, wherein the user device is further configured to overlay one or more of the first content and the second content.
 23. The communication system of claim 20, wherein the first content comprises a television signal.
 24. The communication system of claim 20, wherein the second content comprises one or more of an alert, a notification, and a reminder.
 25. The communication system of claim 20, wherein the interface device is further configured to selectively simultaneously transmit the first content and the second content to the user device.
 26. The communication system of claim 20, wherein one or more of the first service provider and the second service provider is a home health services provider.
 27. The communication system of claim 20, wherein one or more of the first service provider and the second service provider is a television service provider.
 28. The communication system of claim 20, wherein the interface device is selectively operable to transmit one or more of video signals and audio signals to the user device.
 29. The communication system of claim 20, further comprising a system management station coupled to the broadband data network, the system management station remotely located relative to the user device, wherein the system management station is configured to authorize one or more of the first service provider and the second service provider to communicate with the user device.
 30. The communication system of claim 20, further comprising a medical device coupled to the interface device, wherein the interface device is configured to transmit data signals received from the medical device to one or more of the first service provider and the second service provider.
 31. The communication system of claim 20, wherein the interface device is further configured to determine the appropriate path of the first communication path and the second communication path for establishing connection between the user device and one or more of the first service provider and the second service provider by further determining: whether the broadband data network is available; and whether the broadband data network has a quality of service (QoS) level sufficient to support two-way video/audio connection.
 32. The communication system of claim 20, further comprising an audio receiver coupled to the interface device and a digital imager coupled to the interface device, wherein the interface device is configured to transmit audio and video signals received from one or more of the audio receiver and the digital imager to one or more of the first service provider and the second service provider.
 33. The communication system of claim 20, wherein the determination to interrupt the first content is based upon one or more of a predefined schedule, a type of content included in the second content, or an urgency of the second content. 